Haiti, part 2

I said I was going to dedicate this post to the Creole food of Haiti, but after today at the clinic, I have to use this post to just vent for a bit. If you don't want to hear my rantings and complainings, skip this post.

Another warning, I mention a minor surgery during this post, so if you get queasy easily, you may want to skip that part.

Today started off as any other day at the clinic, I got there a little early, 7:30, and waited for Leo and Jorge to get there so we could go get started on triage. When we were all ready, we headed across the small lawn separating the clinic from the outer road. There were probably 300 people waiting outside and they formed two lines, one for "ti moun", children, and one for "gran moun", adults. Shortly after they were organized into lines and we starting triaging people, a fight broke out at the beginning of the lines, whic merge at the one entrance onto and away from the road. I don't know what exactly happened, but there were bags being flung at others and yelling and shoving, none of which helps the mob of people waiting their turn to see the doctors. Jorge got in the middle of it (Jorge is probably 6'4" or so and not a slight man, by any means. He's a great doctor, but he was almost scary when he tried to break up this right) and he managed to break it up, but we werew all pretty shaken up by it...I almost expected weapons to be drawn.

Back to the patients; we each have our own numbers we hand out to people, they are pieces of wood that have been painted a color (green, black, red, or yellow) and have a number on it. I have fifteen numbers, since that's usually sufficient, but today, I wrote an extra 18 numbers, so I had a total of 33 patients to see.

Triage starts like this: I start in the middle of a line and work backward and Jorge or Leo starts at the beginning and, if things go as planned, which they never, EVER do, we end at the same time. After I had seen about two children, people started to mob around me and shove their children at me and just yelled the kids' symptoms at me. People are grabbing you, wanting you to see their baby next. It's heart-breaking and absolutely infuriating at the same time, I couldn't decide if I felt like crying or screaming or just leaving them all out there.I tried to tell them to get back into line, but my Creole is so limited and they were so afraid they wouldn't be seen that they just continued with their mob.

It took about 30 minutes total, thankfully without another outburst, to finish the triage. By that time, Leo, Jorge, and I are ready to be done for the day. Emotionally drained and physically disgusting, Jorge and Leo take showers before seeing patients, but I had 33 to see and I got started right away.

In order to see patients at the clinic, you have everyone wait in a common room, outside, but covered and with plenty of seating. I go out to call my first numbers and nobody comes forward, so I think those people have left. I just allow the next person with my color of card to come see me and I get started with the day. I saw a man with a huge wound on his foot, he said he had had it for about 2 weeks, it was severely infected, and I got to wash it and bandage it (for all this griping, I will say I am getting MUCH better with wounds. They don't gross me out nearly as much as they did before coming here. And it's only been 7 days at the clinic) and he also spoke some French, which I am much more comfortable with and I also got some Creole words figured out with his help. I saw some babies which I examined for their 1 month checkup (at the clinic, we are keeping a record of some mothers who come to see us during their pregnancy and we follow them throughout their pregnancy and follow their baby for 1 month, checking in on them at 1 month, 3 months, 6 months, and 1 year). I also saw a little boy who has been to the clinic twice before due to a severe burn on the back of his hand (it's healing, but it's slow and it's still incredibly raw). The majority of the patients I see, however, are just babies who their mothers say have "mal a tet" or "mal o vent" or "pa manje". They all say their children have the flu, and indeed, we think the swine flu has hit Haiti pretty hard, but we just don't have the resources for giving medicine to everyone. If we gave medicine to each child who is reported to have the flu, we would be out of medicine in maybe two weeks.

(Just as a side note, if you are able to talk with your doctor or a hospital about providing medical supplies to this clinic, let me know and trust me, the medicines will be used well and will benefit many).

It was not all in all a terrible day, I did get to learn some more Creole and I also had some students follow me today, which is interesting. Although the group from today was not as well behaved as lasst weeks group. They didn't really help, they mostly sat around or meandered in the halls and just took up space. Maybe it's just because this is their first day. I guess we'll see. They did get to see a pretty interesting minor surgery, though, one which I will not soon forget.

Leo works across the room from me and he needed my help to lance an abscess on a baby's head, so I agreed to help. We help each other as much as is humanly possible, since we are all fresh out of school and figuring things out as we go. To lance an abscess, you usually numb it with some lidocaine or something, they you can make the incision. But lidocaine is used very sparingly, so we don't use it unless absolutely necessary. Leo made the incision and pus came out, which is absolutely normal. But the students were watching and I think some of them were ready to pass out. You have to also squeeze and flush out the abscess to make sure it is clean and there is no more infection left and the incision can heal correctly. (Warning: this may get graphic) Leo had to squeeze the abscess, the baby was screaming and wiggling all around, and the abscess must have popped or something and pus and blood flew onto the wall behind the baby's head. The students did not stay long after that. I don't blame them. But the abscess is gone and the baby is healling now.

The rest of the day, I gave out dried milk for babies who seemed under-fed or to mothers who had trouble breastfeeding because they didn't have enough nutrition for themselves and the baby. I also gave out Tylenol, Jr. almost like it was candy, which we also give out sparingly. I listened to so many hearts, lungs, and abdomens, I am hearing them in almost any quiet moment. It was an emotional day and a very, very long day (I was working from 7:30 to 3:15, with a 15 minute break for lunch. Not a typical day, either, since we usually only work from 7:30 to 1).

I promise to dedicate the next post to food, it will be a welcome change to this medically-themed entry. I hope tomorrow won't be so crazy.